Provider Demographics
NPI:1083624308
Name:WINSTON, THOMAS SANFORD (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:SANFORD
Last Name:WINSTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8337
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79114-8337
Mailing Address - Country:US
Mailing Address - Phone:806-355-6593
Mailing Address - Fax:806-352-8774
Practice Address - Street 1:2400 LINE AVE
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-6639
Practice Address - Country:US
Practice Address - Phone:806-342-4722
Practice Address - Fax:806-322-1644
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2018-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK2827207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX096838003Medicaid
TX4418920001OtherCHAMPUS
TX4418920001OtherDME
TX8B0300OtherBCBS
TX127126100OtherFIRST CARE
TXCL8509OtherLAB
TXP00039528Medicare PIN
TX4418920001Medicare NSC
TX4418920001OtherDME
TXCL8509OtherLAB